Joe Moore: All right. Here we are. Welcome back to Psychedelics. Today I am joined live by Case Newsom, medical Director at Sendo Project Stadium Medical, is that what it’s called? That’s right. And an emergency room physician working in Denver.

Dr Case Newsom: That’s right.

Joe Moore: Uh, we have a visitor try to keep that dog out.

It’s like typical ER

Dr Case Newsom: work, right. Just getting into it. And,

Joe Moore: yeah. So, um, we have a lot to get into today. I’m really excited because, um, you know, I’ve been a fan of Zendo for a long time. I, and I actually got to see you all work at the recent Phish shows in Boulder. I, you know, went to two of the three nights.

I, I missed one of our mutual friends who worked only the, the middle night. But, you know, just, um, excited to chat about that. Excited to chat about this kind of medical protocol you put together that got implemented. So went recently at Zendo, a Burning Man, and, um. Yeah, there’s just so much [00:01:00] else we can talk about.

So I hope this is the first of many.

Dr Case Newsom: Absolutely. Thank you for having me. Really excited to be here. Beautiful home. Beautiful warm vibes from you, Joe. I appreciate the opportunity.

Joe Moore: Yeah, I’m really, yeah, thank you. And thanks for driving up for this. I, I always love it when people make that effort. It’s just nicer to be in person.

Dr Case Newsom: I got to hang with the troll for a minute there and wander Breck for a bit. I haven’t been here in a couple years. Gorgeous day for it.

Joe Moore: Mm-hmm. So let’s kind of, um, before, before we were running the tape, can you give us, um, what is Zendo Project?

Dr Case Newsom: Sure. Zendo project is a harm reduction group that utilizes.

Peer support principles. Our main focus is on supporting people through not down. We work at events. We have an education outreach, uh, program as well. The entire focus is on helping individuals feel resourced to sit with individuals that are having psychological distress. And we don’t [00:02:00] have any particular methodologies or practices per se, that you are bringing tools into those encounters, but rather you’re just trying to act as a grounding space for people to be able to process what’s emerging for them, whether it be psychedelic oriented, psychoactives of other sorts, or even just psychological distress.

Um, anybody that seems to be having a challenging time. We’re more than willing to help. Um, we started at Burning Man over a decade ago now and have subsequently come out from Burning Man into other expressions in the, the festival scene. Um, other psychedelic industry expressions. Um, and it’s honestly been this really beautiful growth of.

Those principles now starting to manifest in other groups as well, doing similar things. And now where, when I was joining in, there was this obvious collaborative intention with medical individuals, EMS, emergency medical services, or the healthcare establishment at creating safe [00:03:00] containers with specialization.

And how we’re able to respond to emergencies in large gatherings is kind of where I am mostly utilized, but also working in an education way of helping teach individuals that are in therapy positions in healthcare, or even just in social settings. And having that composure and being able to, as we say in medicine, take your own pulse first and be able to create a safe place for people to be vulnerable.

And hence the name Zendo Project. ’cause the Zendo is based on the methodologies of going into a space sitting. Sitting. Sitting until it hurts and then continue sitting until it no longer hurts anymore.

Joe Moore: Mm-hmm. Mm. Yeah, I, uh, I’ve always been kind of, um, itchy around zen practice itself, but I understand, and you get a lot of that with sitting with people like I, you know, um, it’s no secret.

Dobbin spent a lot of time in Hochberg breath work and there’s a lot of [00:04:00] sitting Absolutely. And a lot of not doing. Mm-hmm. Um, which is humbling. Right. But that’s like your presence is the thing often.

Dr Case Newsom: Absolutely. Yeah. I would say that this is, uh, an intention that’s outside of Zen practice or Buddhism in particular.

Um, but that we were gifted a zendo by, uh, Buddhist practitioners at the beginning of the project, and it only felt like it was a perfect, um, space for us to do the work that we are trying to do. But of course, we have gone beyond that structure now at this point where it was literally a physical space at Burn Now.

I mean, we’ve done. Zendo project inside First Aid at Red Rocks now, like it’s literally on a, a gurney in the corner, you know, and we can create that space even in chaos. I mean, we’ve had Zendo project, uh, sanctuary next to stages at festivals where it’s super loud, you know, but even in the midst of all that, you, with your human element as a sitter, you can still [00:05:00] help occasion something profound that’s going to be coming through energetically and the person needing the help.

Um, and you can just do that even in the midst of chaos, as long as you are grounded yourself. Let’s talk a little bit about stadium.

Joe Moore: Absolutely. What is Stadium?

Dr Case Newsom: So Stadium Medical is, in my opinion, the top of the line event medicine, EMS agency. They’re special in that they don’t do a ton of, I guess, I guess I should say, we, we don’t do a ton of festivals per se, but rather we are based in Denver and we cover essentially all significant concerts and sporting events, um, and gatherings in the Denver metro area.

Mm-hmm. And, and beyond a bit. Um, but we cover, say, uh, empower Field, uh, we cover Red Rocks Ball Arena, mission, you name it, Folsom Field, which we hung out at Phish. Um, and so their job is to be a legitimate healthcare. Front facing service at these large gatherings, [00:06:00] but it’s based in venues. Mm-hmm. So they don’t build up spaces and break them down, like say, um, a more festival focused EMS agency.

We have transporting ambulances. We do have a 9 1 1 catchment area. Um, we do inter-facility transports taking a person, a patient from one hospital to another. So it really is a full fledged, uh, agency and they are spectacular already at providing a skillful medical encounter. Mm-hmm. But they, mm-hmm. Also, because this has been their business for like 20 years, they were already getting pretty skillful with what the Zendo project does.

Um. So I was put in touch with them a few years ago when I started helping coordinate physicians, working some of the heavier shows at Red Rocks so that people could be managed right there on site rather than, you know, in having a ambulance transport to an er. You know, we’re now, it’s an even worse condition for those people to be experiencing something be deep and [00:07:00] profound.

And when I was working at Red Rocks a few years ago, it, it just kind of became this clear relationship between me and the stadium folks that I appreciated what they were doing and their wisdom there. They appreciated that I was, um, bringing some bonafides in the psychedelic world and in prior event medicine that I had done.

And so it ended up working out that their medical director at the time, um, who has a great legacy retired and I came on as one of two medical directors for them. Um, I focus on the event medicine side and then a buddy of mine, um, a. The very good Dr. Sam Smith covers the 9 1 1 and IFT and yeah. So it’s been a, um, a career deepening for me to be able to bring my emergency medicine and my, uh, psychoactive medicine knowledge into that context there and stadium is flourishing.

Honestly, I couldn’t be happier to be working with them.

Joe Moore: Mm-hmm. And, and this kind of thing is not part of normal med school rotations. Right.

Dr Case Newsom: Not quite, I would say that, uh, [00:08:00] there’s a lot of personal learning in medical school. Mm-hmm. Perhaps. Yeah. You know? Mm-hmm. It’s, it’s a very, I, I really love medical school.

Um, many physicians. Where did you go? I went to a school called Lake Erie College of Osteopathic Medicine, and I went to a, uh, a satellite campus in near Sarasota in Florida, which was pretty spectacular. I’m studying on the beach all the time. Um, I was there with my now wife. She was a year ahead of me as well.

And it was a really glorious time. Um, but when you’re reading and studying all this, and, you know, we were talking earlier about systems and you’re getting into the way the body works with itself and how complex it is. Also, how beautiful that this could even emerge from hydrogen atoms from the sun, you know?

Joe Moore: Mm-hmm.

Dr Case Newsom: Um, it’s an opportunity there to really start to work with altered states, um, to really understand in different ways how this really manifests. Um, it’s, it’s just. Brilliant to be able to dig into that. And when you’re in school, you have nothing to do but study, [00:09:00] right? Like that is the main thing.

Mm-hmm. And you’ll never have that kind of freedom or, um, the expectation that you have time to read forever. You know, you get into clinical work and now studying becomes very tertiary to your prime objective, which is seeing patient, patient, patient. Um, so that was a really formative time for me.

Residency as well, when you go on and you do your actual clinical deepening after your basic studies in the classroom. And all of that was, was, I mean, I was starting to get into event care then as well. Um, that was playing music a lot and, um, discovering arts, discovering poetry. Um, I was in Pennsylvania, I was hiking a lot, uh, somehow in residency, finding time for all this.

And, um, yeah, the qualities that have led me to be a good fit with Stadium Medical were emerging at that time. Um, and yeah, honestly, I wish I could have the kind of time to just read again

Joe Moore: and

Dr Case Newsom: as soon as I started getting some time to myself, I had kids, you know? Mm-hmm. And that’s a whole nother personal study

Joe Moore: that takes [00:10:00] a lot of time, it turns out.

Yeah. Can you, before we, um, I kinda want to like rewind the tape a little bit too, but before we do that, um, how, how did you make the decision around like, um, allopathy versus like the do path, like osteopathy kind of path?

Dr Case Newsom: That’s a great, great question. Thanks for asking that. Um, the things that drew me towards osteopathic principles were that it feels a lot more.

Holistic to me. And that’s kind of a trope to say so, but it comes from somewhere that really is the case. You think a lot more about how the musculoskeletal and nervous system then manifest illness when not tended to or maintained properly. And so there’s a bit more of an intentional prevention sensibility with how you encounter the body and how you think about patients and the situations they’re in.

And one step beyond that is once you understand how you can engage a person’s better health, they can get towards good health by how they [00:11:00] move, how they live, how they exercise, how they eat, how they breathe, all that, um, you can start to empower patients to their own good health rather than just supplying a corrective, um, like a pharmaceutical or something, which.

I mean, love pharmaceuticals, they have their role. We have some technological whizzbang imagery, you know, in medicine that’s really great. But being able to quickly show a patient, um, where they’re holding tension, where their posture is not necessarily in their favor, you can actually coach them on a two or three minutes exercise or some sort of movement or breathing technique that then they can take for free with.

Mm-hmm. As long as they just have the intention and are willing to do it. And it’s also helped me in my own health, right? I mean, I’m nearing 40 things are starting to hurt, starting to have those aches and groans and things. And the way that you move is how you heal that stuff, you

Joe Moore: know? Mm-hmm. Great.

Awesome. And then how did, um, how did this whole kind of, well, what came first, like event [00:12:00] medicine, like stadium or the zendo interest?

Dr Case Newsom: I started working with Stadium Medical about five or six years ago when I took over coordinating.

Joe Moore: Mm-hmm.

Dr Case Newsom: And, uh, coordinating at Red Rocks. That is. Um, and I started working with the Zendo project formally at Psychedelic Sciences 2023.

Um, I’d had some prototyping discussions with, uh, Chelsea Rose, the executive director, um, and a couple other staff members at Zendo prior to that. Um, and we’d kind of hashed out like, what is a medical director? What could a medical director do for you? Um, you know, Zendo project is a front facing harm reduction entity.

It wasn’t immediately obvious that you would need medical bonafides for that. Um, but once you are stepping into. Peer support and harm reduction alongside healthcare entities or security. Mm-hmm. Service lines like you’re gonna need to have some amount of [00:13:00] medical assessment and observational skill. Um, and so that discussion I was able to have with them intelligently because of my few years being a medical director with stadium and understanding how you, you know, teach individuals that are looking to you for knowledge, um, and how you create protocols, how you ensure adherence to them, how you do quality assurance, improvement and so on.

And really just being part of the flow as somewhat an advisor, somewhat a director, somewhat a clinician. So it felt very natural to start working with Zendo project because I saw some simple things that could be done, you know, um, and to my knowledge, uh, nobody had really had that discussion with them specifically.

Now, Zendo project. The people in there are very bright, like they were getting a sense that they were needing something like this. Um, but when I was able to come and give it some heft, then it became pretty clear. But I couldn’t have had that discussion were it not for Stadium.

Joe Moore: Mm-hmm. And

Dr Case Newsom: similarly, excuse me.

Uh, one of the reasons I was able to help Stadium so much too is that I had [00:14:00] started. Creating some content and lecturing EMS agencies and police and sheriff departments and things in the activism days, you know? Mm-hmm. In 2018, 2019, and the decrim phase there in Denver, and it was clear that physicians and first responders were gonna need a little bit more education on how you can maintain composure with these sorts of encounters in the field when individuals are having a, a hard time.

Um, because it can be very volatile in the wrong setting. And if you don’t posture with comfort and leading with your warmth, then that’s gonna encourage that person to spin out even further. And so that con, that content I was developing and starting to, to lecture and um, and hearing some of the back and forth with some of those first responders was informative for how I could also then bring that wisdom to Zendo project as well.

Joe Moore: Mm-hmm. We’ll see how that light goes. So, um, yeah, it’s hilarious trick your has arrived. Yeah, I’ll fix that in a minute. So [00:15:00] the next thing is like, is there, is there like a unique set of concerns for Colorado based events? Like you getting started at Red Rocks, for instance? Like you probably saw some somewhat unique things.

Dr Case Newsom: Yeah, that’s a nuanced question. Um, what I would say is at. At the fundamental level, Denver and Red Rocks in particular have clearly become, uh, a destination for EDM for individuals that are looking for a spectacular experience. And a lot of it, of course, is, um, is young individuals that are new with the medicine, if you will.

And so just the population density and the number of, uh, incredible events that we have here is special, I think, um, in a way, I mean, I’ve had people that have traveled all the way from Europe and Asia to come to Red Rocks, and I’m taking care of them for their altitude sickness while they’re partying, you know?

Um, but the, I feel like we’ve crossed a, a critical mass [00:16:00] of Denver and Colorado at large, being a beacon for safe accessible. Experimentation with Psychoactives. And in a large part, I’m, I’m for that, it’s just that we do need to be skillful in how we can respond to that to keep safety, you know? Um, as far as Colorado, otherwise, I mean, there’s certainly regulatory stuff that’s unique.

Um, and the legislation that we’ve, we’ve seen and all the activism that we’ve engaged in, it’s a hotbed for discussion on how to do this right? How to do this well, maintain accessibility. Um, and there’s other people that could speak more fully about that, but we’re all in it here. Mm-hmm. You know?

Joe Moore: Right.

Like, this is, this is a hotbed for it. Mm-hmm. And it’s like the. Um, I guess the legal situation is, and, and, and like really the cultural situation such that, like, this is definitely, this is just part of the fabric of this place. Like, I didn’t, like, I was trying hard to [00:17:00] access this kind of stuff when I was in New England, in like Boston, and I could not, I could not figure my way out, uh, to like get, get involved in some way, even though it was hosting Burning Man meetups and like definitely all these things.

Um, it wasn’t until I was here and really engaged in the Phish world that I was able to actually, like, um, I did all of this study and then it took like, oh, I had to go to a Phish show and that was it, a show with the right people. I was going to Phish shows before I had access, but, you know, yeah. With the right people.

And then I was like, oh, cool. And you guys have this kind of like group care framework already built in, in your community For sure. ’cause Phish shows didn’t have Zendo project and, you know, and, uh, we can get into that in a moment. Not yet, no. And um, yeah, it was just, it was a fascinating and cool culture to see developing and sure, there was a lot of overuse and sure I was an over user, but that was radically educational for me and actually helps how I show up now for psychedelics today.

Dr Case Newsom: Mm-hmm. I think that’s a great point. Um, you know, Timothy Leary famously said, find the others, [00:18:00] you know? Mm-hmm. And, uh, there have been these nodes. That occur naturally since?

Joe Moore: Mm-hmm.

Dr Case Newsom: Well, I mean, probably, honestly, before I could even really think of it, but certainly in the sixties that we all understand and it feels like Denver is at that point now where, um, you can go there and rest assured that you will find others, if you will.

Yeah. And I mean, just the other day I was walking through the Rhino, uh, with my wife. Um, we had gone to this wonderful jazz show and then we were wandering just down the street just to take in the sights. And um, I mean, there were shows happening in the back of bars that felt like little miniature EDM Yeah.

Bangers.

Joe Moore: Mm-hmm.

Dr Case Newsom: And there’s people all over the streets that are pushing psychedelic art and materials and so on. You walk into some of the newer bars and it’s just clearly informed by the psychedelic experience and it’s just right there in the nightlife. Mm-hmm. I’ve just had never seen anything like that.

It’s same back. Shout out, shout out

Joe Moore: to Beacon and Mockingbird. I’m sure there’s plenty of others, [00:19:00] but you know, it’s, you named it. Yeah. It’s really, really beautiful venues and just the design and like, you know, so beautiful. It’s not just about maximizing sales at the bar, it’s like, seems to be fundamentally about connection.

Dr Case Newsom: Yep. Maximizing the experience there feels like. Mm-hmm. Yeah. We wandered through before it got busy and I was still like in awe I had never been. Mm-hmm. I was in Beacon particularly and amazing. Honestly. Right. Definitely aimed to bring some folks there and Patron there.

Joe Moore: Yeah. Yeah. I love it. And um, yeah, so it’s in, it’s in the fabric of the place and we were at a point, um, kind of sixties, seventies counterculture hub, like famously, I think Bear Oley spent a bunch of time here manufacturing, uh, LSD and probably plenty of others.

So, you know, it’s, and the way I put it in the music scene is, you know, not every New York band or Florida band makes it to la. Not every LA band makes it to New York or Florida. Everybody makes it to Denver. Pretty much. And like when I started like engaging in the music scene here, [00:20:00] I was flabbergasted by my level of access to music and, you know, with nightlife and music comes substance and, you know, um.

It’s, it’s a, it’s a fascinating cultural experience and experiment.

Dr Case Newsom: Totally. Coming from Florida, I’ve always thought of Denver in terms I could understand having grown up there, it feels like a port city,

Joe Moore: you know? Yeah.

Dr Case Newsom: For the ocean of the mountains, if you will. And everybody just stops in here. There’s like this great continental divide.

Mm-hmm. And it feels like you just gotta like metaphorically gas up, fuel up, get inspired, ground down in Denver, and then move on, continuing in your flow. And yeah. I couldn’t feel luckier to be living here. And I, I don’t know if there would’ve been this career path that I found myself on, kind of bridging harm reduction healthcare outreach, still maintaining my emergency medicine work, but having all of this other opportunity to make a difference.

I’m not sure I would’ve been able to do that in any other place, honestly.

Joe Moore: Mm-hmm.

Dr Case Newsom: It’s hard to prove a negative. I’m not in those other places, but, um, there’s just no [00:21:00] question that it’s a feedback loop here. I’m feeling fully inspired by where I’ve landed and we’ll continue on deepening all of this, you know?

Joe Moore: Yeah. Um, so Zendo was kind of, has an interesting founding story. It kinda like came about in Burning Man a lot of interesting ways and, um, it developed into a really interesting cultural institution. It’s a, it’s a 5 0 1 C3 on its own now, but it was historically fiscally sponsored by maps, I think.

Correct, correct. Yeah. And now, now that it’s standing on its own, I’m really curious to see how it will unfold. Um, but what it has done, you know, beyond how it’s gonna unfold is inspired a lot of organizations to start up more local, um, regionally appropriate, I hope, organizations offering somewhat similar services.

Have you, have you all kind of thought about that or thought about how you’re inspiring elsewhere? Uh,

Dr Case Newsom: we think so much. It’s one of my favorite things about these people. Um, I, I’d like to speak on the regional Yeah. Point there. Um, we have been [00:22:00] brainstorming how to create. Something like a dispatchable model in which we can help encourage local individuals to coordinate and execute on their own.

Harm reduction version. Mm-hmm. Um, we’ve been lovingly calling it like zendo in a box, you know, where we could literally just send supplies and create some task sheets and some know-how. Um, and vet a coordinator, for instance, train them up and then they can start to roll it out. Um, where we know that the principles will be upheld, um, and kind of how we do our process both.

And that includes how you build the space, how you interact with other service lines, how you have the tactical approach that we have for green dots in the field, like just doing the work. And this is one of the big things about the Denver pilot that we’re engineering, where we’re starting to create a small regional, like spoke and wheel sort of model right there.

Mm-hmm. For how we can do these events more on a weekly basis kind of deal. Mm-hmm. And then we’re hoping to study that [00:23:00] honestly, and we’re gathering data from participants and the services that we’re working with, hoping to do an impact assessment. Mm-hmm. Study this, publish it, and this can encourage more adoption.

In other metro areas or other regional smaller events like say Regional Burns or other festivals. And I, I would, I would just love for the way that we do this work to just happen everywhere, whether it’s Endo Project or not. Mm-hmm. And I mean, there’s no question that the, the brand is super recognizable and I’m, I mean, every time I wear a shirt like this, I’m getting hollered at, it’s awesome.

But it doesn’t have to be, it could just be anyone that’s doing a thoughtful, skillful approach at harm reduction. And you are definitely starting to see that now. Um, but one of the big questions is. How do you get the industry at large, whether it be healthcare or first responders or you know, the music industry and venue producers, et cetera, to understand that this is a version of harm reduction that is much more tactical and skillful as a point of care, as opposed to disseminating information or [00:24:00] offering, you know, drug testing and this kind of stuff, which all super valid.

But harm reduction is such a huge tent term now, and Zendo project, I feel like is one of the pioneers at helping create a actual service out there covering the field. Mm-hmm. And you are seeing that everywhere now and it’s beautiful, but I really hope that we can expertly create that crafted so that we know that the model will work and be sustainable in the future.

Joe Moore: Yeah. There’s um, a few things here. So, um. There’s legal stuff that gets in the way sometimes for how we actually want to help people based on the science and based on experience. And that’s stuff that really needs to get worked on and figured out, right? Like, I don’t, I don’t know the answer other than probably let’s eliminate those laws that are getting in the way of us helping people.

Um, but the, the part two here, there was a presentation at Horizons, I think probably 18 or 19, I think it was the same year. Carl Hart was there. I think it was 19 maybe. [00:25:00] And, um, this presenter from the uk, I think from the Loop was this really amazing organization over there. They implemented, actually not, not Zendo style work, but more like drug checking work.

Mm-hmm. 80% year over year reduction in hospitalizations by one. Implementation like that. My gets gracious. Wow. You know, that’s England. It’s not Denver. England has a different drug culture Sure. By a long shot. Um, but you know, by, so this is the thing that is actually in fact often illegal. Not, not what Zendo is doing.

Zendo is quite legal, but like actually being able to say, Hey, is your thing safe or not? Cool. Great. No, it’s not. And a lot of people were just throwing out the stuff that they mm-hmm. You know, had after their anonymous testing.

Dr Case Newsom: Yeah. Um, thanks for naming that. That is incredible stat. I had not heard that.

Um, I need to find that and read about it. Uh, not surprised though. Um,

Joe Moore: because when we know our dose and actually what we’re doing, which is a problem with prohibition and drug markets in [00:26:00] general, um, we can then make more informed decisions. Not like, here’s some ibuprofen powder. You know, good luck.

Dr Case Newsom: You were speaking to my civil liberties perspective here, man.

Yeah. It feels like we should be able to be knowledgeable on what we’re buying, and we should have the autonomy and agency to pursue whatever sort of mind alteration we want, and it should just make it so it’s as safe as possible by having it be open and mm-hmm.

Joe Moore: Uh,

Dr Case Newsom: easy to vet, you know, and I know that that’s a whole deeper conversation, but I mean, famously, one of the things that gets in the way of us doing our work as well as, you know, epochal organizations like Dance Safe and SSDP, these other groups are amazing, is the Rave Act.

It just, it gets in the way of producers or legislators feeling comfortable at working to promote safer practices. Event

Joe Moore: producers, not drug producers here. Did I say drug producers? You just said producers. Oh, I just wanted to specify Event producer wanted specify.

Dr Case Newsom: Totally. Yeah. Um, drug producers keep doing your thing safely.

Please, please. Um, yeah, it’s, I mean, it, it makes it [00:27:00] so that, uh. We already have an uphill climb at being able to bring best practices into these industries because of the fearfulness for these in these folks that are putting on big events. It’s going to look like, like in a legal sense, that they’re aiding and abetting illicit use.

And I just like, I have so many issues with that. Like just like how you, you can’t stop individuals from. Being the way that they are. Why in the world would we just continue to worsen their predicaments in the event that they get their head over their skis or get into something that’s impure or that they’re in a uncomfortable setting?

Mm-hmm. They’re being tackled, you know, and restrained and sedated even instead of being able to be supported through like,

Joe Moore: yeah,

Dr Case Newsom: it just on on every level. It’s meritorious for me to bring harm reduction in, but I do understand that there’s a lot of regulatory issues there, and since I’m not somebody that has capital or has the opportunity really to create these spaces [00:28:00] overall, like a festival or like a venue, I understand it gets really in the weeds, but we all need to.

Form a coalition and advocate against some of these laws, in my opinion.

Joe Moore: Yeah. I was on the phone with my county health department ’cause I wanted to like understand what their positions were. Um, like one of the few places in county, I think they’ve improved it recently and we we’re kind of like a county thing ’cause population’s so sparse here.

Sure. Um. Was they, you know, they, to pick up fentanyl test kits, you have to go to the sheriff’s department, which like, I have some, you know, strange opinions on because like, do I want to go be near police? Usually? Not usually. Yeah. Like my boy Sarco, I’ll go hang out with, but like, and Diane from, from Leap for sure.

But like, I, I like, I have a hard time saying, oh cool, like, I’m about to go do drugs, let me get these things from you guys. And, and you know, um, I, I think that’s, um, misguided and kind of like a strange use of [00:29:00] tax dollars when we could say like, okay, what’s the easiest way to do this and get this in front of people?

It’s clearly not making them go interact with police who they’re already kind of nervous around. Right? Yeah. Um, so I was chatting with them about that and then I’m like, okay, cool. What do you have next? Oh, a needle exchange program. Great. Cool. But. How much bloodborne pathogen is happening from like needle users in this county.

And they couldn’t give me any figures. Wow. They’re like, we just got the grant, so we’re doing it. I’m like, Hmm. And then I was like, okay, here’s, here’s what you guys wanna do. If you wanna reduce deaths a lot. And hospitalizations a lot is county based anonymous drug checking. And they, they just kind of freaked out and got nervous because politicians and like government workers are kinda inherently conservative ’cause they wanna keep their job.

Dr Case Newsom: Totally. Yeah. It’s, um, it’s really hard to do the right thing. Um, there’s also some practical limits to being able to. Create excellent data. Mm-hmm. Um, and be able to process it [00:30:00] through. Um, a good example would be, uh, when I, I was asked, uh, recently by a large city in Colorado. I’m still kind of working on this relationship, but, uh, they’ve asked me to come and lecture their, their 9 1 1 dispatch team, like the entirety of fire and sheriff and police and their nine one one call center dispatchers and stuff.

Can’t wait. And I was talking with them about, um, data and, you know, how many encounters do you think that first responders are having? How many calls, um, how long does it take to get to psychoactive related or psychological crisis calls? And they’re relying on a lot of. I mean o older software in the first place, um, or imprecise, uh, detailing of what an encounter really is.

So then they’re relying on, well, what does the doctor in the ER diagnose the person with? And we’re gonna try to work backwards from. Oh, okay. So clearly we are gonna know how many people are using LSD and having crisis because [00:31:00] it’s gonna say so in the, in the medical books. Right? Not at all. I mean, they, even me, I’m guilty of it.

I just diagnose people with altered mental status. You know? ’cause you gotta keep moving. You can’t possibly dial in the details of every encounter so that then you can do a data poll from software. So there’s just a lot of, um, practical, but also this sort of underlying print like sensibilities of individuals if they’re willing to get into those deeper discussions.

Like the fentanyl test strip, you’re talking, there’s so many things that get in the way of being able to be really intellectual about these. When am

Joe Moore: I gonna be honest with a physician I’m working with about what I consumed? Like that’s a really interesting thing. Um, and then back to prohibition. How do I actually know what I consumed?

Dr Case Newsom: Mm, good question. Adulterants novel

Joe Moore: adulterants are coming like crazy and

Dr Case Newsom: Totally, yeah, for sure. Uh, this is gonna send me down a rabbit hole of the future of designer drugs too, and how it’s gonna be impossible to keep up as we start having more and more developed. The cost of [00:32:00] developing is gonna be cheaper.

You’re gonna have AI that’s like producing like shulgin level compounds, like on the daily, you know? Mm-hmm. It will be impossible to keep up if we don’t have just an open and almost like. Intellectual discourse about this and how you can be an expert in this field, but I don’t know how easy it is to prioritize a career in like drug harm reduction right now.

It’s just, there’s a few people that do it really brilliantly, but they have so many headwinds they’re trying to overcome and I feel like we could get there, uh, with aid of technology.

Joe Moore: AI assisted robotic chemistry, um, or AI owning it is fascinating, right? Mm-hmm. Like, you know, once these things kind of can have their own crypto wallets and like access to like, you know, all these services, it’s gonna be fascinating to see how that unfolds because there’s like, Leonard Picard famously says the amount of like who mm-hmm.

Not only was like, you know, this LSD guy, but the GOAT by the way, he, um, yeah. Find the others. He made a lot of others didn’t he? [00:33:00] He predicted the fentanyl crisis in a, in a, um, paper he did at Harvard, and then it got picked up by Rant Corporation, and this is in the nineties, he predicted the Fentanyl crisis.

Um, and all it takes is unscrupulous actors and a little bit of chemistry and, you know, you can make this thing. And now with the advent and, um, cheapening of computation and robotics and these things like the speed at which this is coming. So to me, that that concept, the way you laid that out, like AI robotics and like, you didn’t say robotics, but you know, the idea is that.

Um, this is a greater incentive for government organizations to work towards deprioritizing, decriminalization and, and potentially legalizing towards safe supply. Mm-hmm. As, as a solution, as a hedge against these drugs that might be wildly more damaging and addicting. Right. Might be. We don’t know yet.

Right.

Dr Case Newsom: So much we don’t know. And the only way tos come to know something is to put a lot of energy and resources and support into it. Mm-hmm. I’d love to see that happen.

Joe Moore: Yeah. So here again

Dr Case Newsom: with maybe Denver is on the front perhaps, you know.

Joe Moore: Let’s hope. I hope so. [00:34:00] Yeah. Um, here to help. Yeah. I love how high speed my rant was there.

Um, I’m here

Dr Case Newsom: for it. I know, I, I was telling you earlier, I usually talk at 1.25 x speed and that’s just the way I like to live, man. I’m here for it.

Joe Moore: Yeah. My audio books are a 2.5, so I know my head can’t keep up sometimes with, uh, what my mouth tries to do. So anyway, like the back to Zendo here. Um, so you kind of entered in 23 mm-hmm.

And you were able to create or co-create a new kind of medical triage protocol. Can you talk about like what was ingredient in that and what, what kind of did you output?

Dr Case Newsom: Yeah, totally. Uh, thanks for asking, man. Getting into brass tacks about the med triage protocol. This is, this is where I thrive. This is my favorite stuff.

Yeah, totally. Um, so. What we needed to do at Zendo project was not only have a person to act as a liaison with emergency medical services so that there was ongoing constant dialogue and making sure radio communications and presentations were clean with who [00:35:00] arrives at the Zendo project mm-hmm. Versus who’s arriving at security or medical from the field, et cetera.

We had to have an individual that’s actually credentialed practices healthcare in some form, whether EMT paramedic, nurse, physician, um, at the front of the Zendo project because we needed to make it that the sitters that are doing the grounding work and observing and validating the person’s experience, they need to feel comfortable that their person is safe, the guest is safe, and we couldn’t ask that every sitter have medical credentials, you know, obviously.

Yeah. So what I needed to be able to do was create a position and a workflow that ensured that we had an observational quality at all times. And so, uh, when people arrive, they are encountered by a greeter that’s getting a sense of if they’re the person is needing support. And the medical triage individual’s job is to, with open and [00:36:00] vulnerable and soft language with composure and the same grounded energy that you would expect of any Zendo project volunteer.

They need to be able to encounter that guest and get a sense that they actually are not facing a medical risk, excuse me. Which is difficult of course, because the special sauce about Psychoactives is that it is very activating and modifies the way your physiology is working. And so people do end up with a lot of abnormal looking medical signs, like vital signs can be abnormal.

Um, they can have altered mental status, et cetera. They could be even presenting delirious, like in our medical term there, where they’re in and out of attention. And a typical medical assessment there. Will be abnormal, just almost categorically, you know, in the event that Psychoactives were used, of course a lot of folks are not using substances when they come to Zendo, but this is a large cohort of our guests.

Joe Moore: Mm-hmm.

Dr Case Newsom: And so I needed to be able to create a protocol that was sensitive to [00:37:00] the abnormalities that are expected. In a person that’s presenting that way so that we could smartly still allow entry so that we’re not just sending every single guest to medical and then they get lost to the peer support services that really they’re, they’re needing benefit from.

And so that was a little bit tricky, but um, with my emergency medicine training and. How I’ve held space for, you know, now decades for individuals under the influence or in the, uh, headspace that’s really activating. I, I was able to build something that allows admittance for most individuals, particularly since we also have the medical triage volunteer coming through the zendo itself and checking in with each sitter and each guest on a routine cadence, like every 30, 60 minutes.

Mm-hmm. Just swinging through and touching base and. I mean, every time it’s, you get on the ground, you are attuning to the guest, but you’re always [00:38:00] maintaining a little bit of the directive of just trying to suss out if they’re having any particular feelings that might be medical, uh, in nature or any sort of distress that’s actually physiologic, um, that has implications for their health safety.

And then you move back to the front and you rinse and repeat. And so it was, it was this delicate thing of, um, sensitivity and specificity, which, you know, doctors talk about all the time of how you dial in the effectiveness of a, of a test or a screen. And that’s how I approach the med triage protocol. Mm.

And I must say, since we’ve rolled it out, um, you know, two plus years ago, we haven’t had a single medical issue in the Zendo, which I think is fantastic. And really, we, we only escalate a handful of folks to medical for each event. Um. To put some numbers to this when we were at Phish, where UME got to kick it for a minute, which was awesome.

Also, shout out to that three night run at Folsom Field. That was incredible. Just a couple weeks ago, [00:39:00] um, I guess it was 4th of July, so a month ago, um, we had an expectation from Stadium. Stadium was working the medical side. Mm-hmm. We had an expectation of maybe 25 to 30 transports over that three night run, and we diverted about 25 to 30 presentations from First Aid towards Zendo instead, like as in, they weren’t even evaluated by medical because we were able to help bring them to Zendo.

Since we have a medical person there that’s able to do some observation and the number of transports we had was only seven. For the whole three nights. So, I mean, it was like an order of magnitude almost difference from what we expected. And we didn’t have a single medical malady, uh, express itself in the Zendo and were that to have revealed itself.

I’m confident we would’ve been able to recognize and escalate them back to medical and Stadium would’ve been more than happy to manage. And then they can go from there with their workflow, or in the event they tighten everything up, they come back to [00:40:00] Zendo, you know? Mm-hmm. Um, so really it is, it’s this beautiful push and pull with, uh, the other service lines that we have where we can actually, using the protocol that I’ve built, offload some of their strain.

Mm-hmm. You know, and make it so that not only are you removing, quote, a hazard from the field where that person could fall, they could hurt somebody else. Yeah. Hurt themselves, whatever. We’re also now allowing them to process their experience. So we’re getting a two for one with that episode there. Um, and they’re doing it safely because we have a medical person there at all times observing.

Joe Moore: I love that. Like, can you gimme like a couple high kicks of things that would make people wanna, you know, get, um, redirected towards med services? Like, uh, uh, irregular heart things, blood pressure?

Dr Case Newsom: Sure. I mean, a classic one, uh, when you are overly exposed at, say, burning man mm-hmm. It’s gonna be that you have temperature dysregulation, right?

So you’re, you’re hot, you’re cold and [00:41:00] resistant to some passive warming or cooling. Mm-hmm. Some people are just not quite getting back to safe temperatures in a matter of 15, 20 minutes, which is where I have that dialed in, then they would go up to medical for more further support fluids, that kind of thing.

Um, certainly abnormal heart rates or arrhythmias would be a, a classic thing that we would get all bent outta shape about in, in healthcare. Mm-hmm. But essentially everybody has an elevated heart rate when they’re coming in and they’re distressed. So we allow for that. You know

Joe Moore: mm-hmm.

Dr Case Newsom: On the understanding that we are keeping close tabs and we need to see it improving in short order.

Mm-hmm. And because of the way we have the space, almost everybody’s nervous system settles, their heart rate improves, but say, uh, we’re talking

Joe Moore: like 10 to 30 minutes-ish, or Yeah. Yeah.

Dr Case Newsom: I mean, honestly, some people it’s within a minute, you know? Totally. Of course, if it’s anxiety or psychologically oriented and they’re having like a reic, you know, adrenaline type response mm-hmm.

They, you, you get into a grounded space and [00:42:00] immediate nervous system reset. You know, other folks, it is that they’re also hot, they’re dehydrated, whatever. Mm-hmm. And so we can support them with those, those basic, uh, peer support items and they get better in, in, yeah. Within a few minutes. Um, and if not, or if they’re moving in the wrong direction, then they go to medical.

You know, um, another one would be, uh, if a person just cannot support their own weight, you know? Mm-hmm. Like, we are not really able to like, manage a person like nurses would be able to expertly assist a person with their body functions and stuff if they can’t hold their own weight. So things like that, we just, as much as we’d love to support them, they have to go to medical.

But of course when we have a good relationship with medical mm-hmm. By having a medical director at Zendo, especially if I’m also a medical director at Stadium, we bring Zendo into the medical area and now we’re able to provide some peer support right there and make the EMTs and paramedics job all the easier so they can focus on the strident medical expression of that person’s.

Uh, issue, you know, as opposed to them also now [00:43:00] having to constantly be redirecting and agitating the patient with all the red shirts and everything, which you need for visibility, but just having a zendo person coordinating within medical mm-hmm. Makes all the difference too. So this really is becoming like a bit of a matrix that we’re able to support in the field, in medical, at the security office in Zendo.

Joe Moore: Yeah. Um, ugh, I wanna go in a million places here, but, so let’s, let’s point out one, one, like really obvious advantage. Um, at this Phish situation, which was extraordinary. It was the first time I think Phish had Zendo, which is great. And, uh, yeah. A lot of people were like, what is Zendo? And so, you know, I had to explain it a lot and I’m sure you did too.

As usual,

Dr Case Newsom: one of the busiest places at any festival or event is in the front of the Zendo project, which is so cool. People are so interested.

Joe Moore: Mm-hmm. That’s where I hung out. Um, but yeah, so this kind of tight integration with your role at Zendo and Stadium, like, you know, that that’s an obvious advantage, right.

And I think in time, [00:44:00] what’s gonna have to happen elsewhere right? Is like similar types of closeness in the organizations and coordination. Um, because you know, if there’s disc coordination between medical and these kind of like, um, zendo style service centers, like how Yeah. Like that’s just gonna have to be something we have to focus on to get that level of performance that you got from 30 to seven Totally.

You know, over three nights, which is crazy that that was a lot of people. It was not a small crowd. No,

Dr Case Newsom: no. For sure. Yeah. I mean, one of the hardest parts when you are still developing a, I mean, we are a scrappy, upstart organization. Mm-hmm. Right? And one of the, the hardest things is just having the conversation at all, like getting to the table with other safety officers and being able to discuss what it is that you actually do.

Mm-hmm. And how we can actually deepen our workflow to be more in collaboration. And one thing that happened at the Eclipse Festival outside [00:45:00] Austin, uh, last year, which my goodness, like life changing moment, I’ve never seen a solar close before. Incredible. Um, there was a, an amazing medical entity there, uh, called um, NES, uh, national Emergency Services.

They cover big festivals by Bonnaroo and, um, electric Forest, et cetera. And they had like, heard of Zendo project, but. You know, it was difficult to kind of have briefing discussions mm-hmm. Ahead of the, the event and so on. And, um, you know, everybody’s busy. Right. And like an additional meeting, you know, uh, with another service line can get a little bit heavy to, to carry all that as you’re prepping for an event.

We got there and at the event it was just kind of clear that there was some, uh, chunky bits with how we were getting guests arriving at the Zendo project. We were like a half mile away from First Aid and like their main like, sort of medical area and, um, we were constantly going to retrieve people from First Aid, et cetera.

They had some [00:46:00] explosive outbursts in medical that I was witnessing and, um, it was making everything feel unsafe.

Joe Moore: Mm-hmm.

Dr Case Newsom: After just kind of like assessing the workflow there and where there was some discrepancies, like we sat down together, me and their operational leads, and we hashed out what supplies do we have?

Um, where can we like share resources? Can we borrow some extra radios? Can we borrow a four wheeler, et cetera, so we can do more of a field response? And it changed everything. It changed everything. Mm-hmm. Our workflow completely dialed in with the, just a few switches and we took that, learned from it, and now we like are bringing that example into.

Pre-event briefings and figuring out how we can start to work with entities that don’t know what the Zendo project is, but we’re, so we started creating things like a one pager. It’s like, this is literally what we do. Here’s how we, here’s who we take care of. Here are the things that categorically are not best served in our space.

Here’s our green dot [00:47:00] sort of approach and our field, uh, response. Like all this stuff so that then it’s easy for individuals and other organizations to realize what we do. You know, and that takes like an ongoing vigilance to be persistently, uh, advocating for your services and how expert we’ve made it.

Mm-hmm. And how professional we’ve leveled up peer support. I mean, that, that’s what kept me with the Zendo project when I was still first learning it and the opportunity to show by example. And we’re starting to see more and more organizations are just kind of now knowing what we do, you know, and realizing that it’s not something that they should have to be doing themselves.

’cause Division of Labor here mm-hmm. Leads to abundance. Let us do this part. Yeah. You guys can focus on your part and they get it. Now,

Joe Moore: do you have, so like over time, what I would love to see and you know, is more data that, that you can point to and stats Yes. To say, Hey guys, like this is gonna lower your burden.

This is gonna lower your liabilities. Like, how, how can we work with you given this [00:48:00] information being true? Absolutely. Are you guys working towards some data sets like that? Yes, indeed.

Dr Case Newsom: Outstanding. It’s, it’s like, oh man, it scratches the nerd itch in me. I’m so happy to be back in research. Um, I just, I love like, uh, sweating over data and the trends and what you can pull from it.

Mm-hmm. So then you can. Orient follow up questions. Yeah. What’s the next thing? Mm-hmm. And so we, we have a, an incredible crew, uh, as a research committee, um, at Xeno Project. Uh, a lot handful of folks that have like PhD level researchers. Um, and they are donating their time, uh, for us to be able to level this up.

And one of the refrains, um, Nima, who’s brilliant and is kind of the de facto lead for research, he says it took this like 12, 14 years for us to go from zero to one. He’s like, and in the next couple of years, we’re gonna need to go from one to 10. Mm-hmm.

Joe Moore: And the

Dr Case Newsom: only way to be able to do that is to really be skillful at data gathering, data analytics.

Then how we are [00:49:00] able to disseminate our findings. And so that is happening actively and it’s one of the benefits of the Denver pilot that I have my relationships with Stadium and have developed relationships with Argus, the security entity that we work a lot with, because I’m able to be this constant interstitial person that can be like kind.

Asking little questions here and there, like, what did you guys value about what we were doing there? Like, can we actually see, like what’s the data? How was it that we reduced the expected transports? Um, did you feel that your reliability was reduced with this? Do you feel that you’ll be able to even maybe down staff, save an ambulance for some nine one one call somewhere else instead of having to expensively up staff every single event that you’re expecting to have psychological distress be a prevailing issue, you know?

Joe Moore: Mm-hmm.

Dr Case Newsom: And like they are responsive to that. ’cause they see that this is value add. And it, it’s, it’s so exciting to me, but it’s also like all research. It’s, it’s slow going, you know? I mean, I published research in residency. [00:50:00] Almost across the board to become a physician, you have to. And so like I remember that it’s a different, uh, timescale than what I’m used to.

Mm-hmm. Um, but that’s cool because it just gives us all the opportunities to start to refine the questions and to then be able to craft an actual publishable, uh, piece that can demonstrate like monetary value and liability mitigation. Yeah.

Joe Moore: All right. So I’m gonna make this podcast even more Real World.

You open that door, so you got a, a puppy that really wants some attention. Hi puppy. Um, and yeah, so this will be helpful. This is the, uh, puppy room. So I, I’ve gone to these festivals and they actually like, have a ongoing joke that there’s a puppy room, and I saw this year at PS 25 that there actually was a dog room, like a therapy dog room, which I found fascinating.

And I think that’s cool as like a sensory thing for some people who can get overstimulated. Mm-hmm. Like I just, I just finished reading, um, a memoir of, um, autistic woman called, um, [00:51:00] oh gosh, I have to, I have to dig for the title, but effectively she didn’t get diagnosed until maybe 36. Whoa. Interesting.

Right. And which is actually really common. And then, you know, probably a little earlier than that and one of the, um. Wa so hard. One of the interesting stats they pulled was, um, one in 36 Americans being, um, diagnosed autistic and, or autistic. I don’t know, like getting an actual diagnosis is so hard.

Mm-hmm. Um, and expensive. And it actually comes with some things, um, jumping too. And it comes with some like burdens. Like you don’t, you don’t, you can actually lose some rights if you get a diagnosis in terms of like organ transplants and things like that. Mm. Oh wow. So in some states I didn’t know that.

Not every state. Um mm-hmm. Yeah. And, and definitely like some countries won’t let you. I, I think visit and or immigrate there, so like, I, it’s, so there’s a lot of interesting things. So anyway, that figure is probably, [00:52:00] um, not as high as it needs to be. Like I think there’s probably more so like sensory rooms similar to Zendo.

Mm-hmm. You know what, if people are having these kinds of like. Overwhelms that aren’t necessarily drug induced, it’s just how their nervous system operates. Right. And then they can, um, you know, go and chill and downregulate. Right. And they kind of get fixed, like you were saying, by like dropping into a lower intensity space.

Totally South by Southwest head. A sensory room, I guess. Maps, not even just the puppy room. They’re in the dog room. Mm-hmm. They had like, um, you know, uh, real deal sensory room. So it’s like we’re getting more and more information. We’re, we’re getting more and more aware of how to deal with neurodiversity.

Mm-hmm. In like, helpful, holistic and like compassionate ways. So I think, I think Zendo kind of plays a part in that.

Dr Case Newsom: I think so. Um, and in fact, we are of course a proud organization with many neurodivergent folks in our midst that brings all different sorts of perspectives for how [00:53:00] to be able to be in support of anyone showing up in need for some grounding and.

One thing I’ll say, we were talking about Colorado earlier. I feel like, um, we’re gonna be seeing more and more individuals that are neurodivergent, that are feeling inspired by the opportunities that psychedelics bring. Mm-hmm. For them to be able to deepen some sensitivities and to help flesh out some of the things that they’re hoping to flesh about the way that their mind operates.

And if we are not resourced well, to be able to support those individuals through their initial practices with these things. Mm-hmm. I mean, here I’m talking about, you know. The entire facilitation regulatory world. I’m talking about decrem and community models. I’m talking about emergency medicine, family, doctors, and so on.

We need to all be skilled at how to have these discussions and do it in a non-judgmental and grounded way. Mm-hmm. So that individuals that are, uh, [00:54:00] on their own healing path or on their own self-improvement enrichment path, they feel the actual support from the establishment, you know? Mm-hmm. Because I’m not so sure that, um, modern medicine, like has it all figured out, you know, on how to help support individuals that are feeling that they want, uh, a different perspective on their neurodivergence, you know?

Mm-hmm. And so I, I want to empower individuals to be able to do that themselves. But of course, we live in a society, right? Like we have to be able to also then support individuals as a sort of back and forth. Nobody can do this in a vacuum, you know? Mm-hmm. So showing up in support of their intentions is important,

Joe Moore: right.

So about five minutes left here. So what kind of big buckets did we not touch so far that you wanna make sure to touch on?

Dr Case Newsom: Oh gosh. Um, I mean, one of the things that I, I’m still very much in the learning phase, but do have a lot of curiosity [00:55:00] about is the healthcare. Ramifications, rather maybe the healthcare obligation to help with the emergence of Iboga.

Joe Moore: Mm.

Dr Case Newsom: Um, which is not Zendo project related at all, and I’m not an expert at all. But, um, having early discussions about how the healthcare establishment needs to just get real about psychedelics and plant medicines in general is. Coming to a fever pitch here shortly because of Iboga. And for listeners that don’t know, although I’m sure most do, there are some legitimate arrhythmia cardiotoxic risks to iboga, though it is such a profound aid mm-hmm.

For so many individuals in their path to healing, that we need to be able to figure out how to have an indust like the industry, the healthcare scene, the regulators, et cetera. They need to have a way to be able to safely roll out these services so that we’re not starting to see it happen in the underground, where people are gonna be put at [00:56:00] risk while they’re desperately looking for access to that.

Mm-hmm. And then having cardiotoxic episodes that would be pretty easily managed in a healthcare setting. But if we do not have healthcare settings for those, that brings in some unnecessary harms.

Joe Moore: Yeah, it’s a, it’s a huge thing. It’s coming fast, like Texas just threw in 50 million. Mm-hmm. And there’s other, other groups throwing in crazy amounts of money.

Ambio and Mexico’s growing like crazy. Yes. And, um, probably other places as well. I think, like, you know, we’re hurting as a psychedelic ecosystem, but the iboga people are doing pretty good right now. Mm-hmm. And for, for good reasons. But, um, this, this cardiotoxic thing is an Achilles heel on this project.

Yes. And we do need to mitigate it and we do need to talk about it. Um, and, uh. You know, when I talk to service centers, um, offering these things, I’m like, um, you know, I, I’m happy you’re being so safe, but I wonder how, based on science, um, like if we even have enough science to, [00:57:00] to inform this practice.

Mm-hmm. Like, do you really need an ICU level of care? Mm-hmm. Um, I, I don’t know, like for sure you need paddles. Yeah. The,

Dr Case Newsom: yeah, for sure. You need, and for sure you need the ability to do iv Right. Magnesium have the cardiac monitor on which, you know, I, I can’t imagine personally being in an extended psychedelic experience with all of the gadgets on and stuff, but it’s kind of like, yeah.

It,

Joe Moore: people seem to not care that much somehow. Yeah.

Dr Case Newsom: I mean probably because they appreciate the safety. Mm-hmm. And they come to it with a very specific intention. Um, and they. They realize what they’re embarking on, you know? Um, but yeah, the, and it’s, it’s such a huge conversation and there’s some really smart folks in the Denver scene and at large mm-hmm.

That are talking about this. Um, but I’m not hearing any. Healthcare reps or physicians, uh, that are actually coming out and like having the early pilot discussions.

Joe Moore: Mm-hmm.

Dr Case Newsom: We need to be able to work towards these [00:58:00] channels for healing that need to be healthcare facility grade.

Joe Moore: Yeah.

Dr Case Newsom: And I mean, if we’re gonna get real on the issues of opiate overuse in America, like we have to have this discussion.

Yeah. In my opinion, you know, but I don’t want healthcare to get so behind on this that then it, it’s like failure to launch. Mm-hmm. You know, or that it starts to happen in the underground and it’s even worse than when the healthcare establishment was caught, uh, unprepared when cannabis, you know, became legal in Colorado and we started seeing all the hyperemesis vomiting syndromes and healthcare like, didn’t know how to handle that.

We figured it out. But iboga is even all the higher, uh, risk honestly, but also huge rewards if we can do it well.

Joe Moore: You gave me a good bridge here. Um, so in terms of opioid addiction, prohibition and um, kind of strange policies, do you feel like fentanyl’s getting a bad rap as an ER doc?

Dr Case Newsom: Oh, I just had this conversation the other [00:59:00] day.

In fact, I love it. I’ve had it a bunch of times.

Joe Moore: Doctors are always great with it.

Dr Case Newsom: Totally. Um, so like anything, it feels like there’s a use case for these. Biochemical tools. Mm-hmm. These neurochemical tools. Um, I use fentanyl every time I go to work on my patients, not on myself, but, uh, there is a skillful use to anything.

Um, and there’s also the safe context for its use for a, uh, virtuous intention, if you will. And I can’t, I have a hard time demonizing anybody, uh, with their use of substances when I appreciate that they have their own coping, you know? Mm-hmm. Um, it’s just that it is easy when you have dealing with an underground market to not be exactly super skillful or knowledgeable on what you’re using.

And so now we’ve made it that your coping is danger, more dangerous than it should be.

Joe Moore: Mm-hmm.

Dr Case Newsom: [01:00:00] Um, so Fentanyl getting a bad rap. I, I think so because I use it. So like, how am I, how am I supposed to use a medicine in my patients, uh, when they have something that’s very painful and then turn around and also be like, eh, like, it’s, it’s probably

Joe Moore: every ER doc, not just you.

Dr Case Newsom: Yeah. I mean, yeah. I will say though, um, we are using more and more ketamine in the ed. Mm-hmm. Um, because of the, well, there’s a few factors there, but, um, one of them of course is like, there’s just kind of an overt sentiment, almost to a point of regulation where you have to minimize your opiate utilization in patients, even in an acute issue as much as possible.

Joe Moore: Mm.

Dr Case Newsom: Now. Partly that’s for understandable reasons. There are plenty ways to help somebody treat their pain. Like we can literally use Tylenol and Ibuprofen, and that helps like 80% of people in the er, you know? Um, and then you can use things like infused lidocaine where you’re actually literally doling nerves for the time that you’re in there.

I’ve not heard of that. Yeah, yeah, yeah. Oh, we could go, we could go deep on all [01:01:00] this. Um, you know, or, um, anti-inflammatories that you give IV are very, very helpful. Ketamine is a rising star, uh, in the ED for not just, um, you know, a, a dangerous psychological expression in which a person’s violent are gonna get hurt, or they’re gonna like, hurt their muscles from straining so much and so on.

Um, but literally at a lower dose just for pain. Mm-hmm. Um, but in a, in the patchwork. We need to have opiates of course, because they serve a very important role on patients with certain conditions. And like we have to be able to honor that. And it’s in the right set and setting, if you will, to go back to Timothy Leary.

Like we create this clinical approach for all these high risk, if you will, substances that we’re skillfully using. Of course, I know exactly my dose, right? I know exactly how much they’re getting when they’re getting it. Nurses are excellent at being able to like scan these things and dial ’em in. So it is like, it’s so clinical and so precise and tight.

Joe Moore: Mm-hmm.

Dr Case Newsom: Um, not, not perfect, but still it’s [01:02:00] pretty good, you know? Mm-hmm. And so much so that I trust. That being said, um, ketamine is really helpful because it’s. It’s a totally novel pathway at alleviating the suffering that’s coming with pain, which is what opiates do anyway. They don’t actually really reduce pain sensation much just takes away your caring about it much.

Joe Moore: Mm-hmm. Um,

Dr Case Newsom: which is great. But Ketamine’s also excellent in that. And, um, I’ve been using ketamine, uh, in the ED since I was in residency. Of course it was, you know, really started just before I started my training being utilized in the ED and not just for surgery, but like for setting joints and broken bones and suturing kids that are gonna have like a trauma experience if you’re holding them down and that kind of thing.

Joe Moore: Mm-hmm.

Dr Case Newsom: And, um, I, I’ve actually found that there are some ways that you can help to. Set the stage with the patient for what’s going to happen when you’re giving them ketamine, um, create the humanity that they deserve. Mm-hmm. In receiving [01:03:00] your healer’s presence, you know, and for me to have the honor of witnessing their suffering.

You can name that. Yeah. And let them know that they’re in a safe place and they actually can have a profound experience while I’m setting their shoulder or something. This has happened a handful of times and, um, I’ve coached the nurses on how to do this now. Um, I’ve coached other physicians and residents and stuff on how to bring the terminology similar to Zendo Project Nonjudgmental, you’re safe here.

Like it’s okay to be vulnerable, you know, trying not to seed their experience with any one thing or another by accident. And then they come out and they had something like a beautiful experience while you’re also working them through something that would be obviously traumatizing, otherwise opiates like, don’t do that, you know?

Joe Moore: Mm-hmm.

Dr Case Newsom: Um, and now admittedly, ketamine for pain. We’re doing lower doses, but still the intentions there, I think we can, we can create multiple benefits with the use of ketamine in an emergency situation that we just don’t talk about. And, um, it, frankly, [01:04:00] it’s not that challenging. It’s mostly just like recognizing your own role as the physician or PA or nurse in creating the setting for that person to feel safe as they’re having some technical work done, but for them, they can have a psychological moment that’s special, you

Joe Moore: know?

Yeah. I love that. I, um, before I tee you up for a, for a close here, I’ll, to share a story where I wish you were the attending doctor. Oh, please. We, uh, my partner and I spent, um, Valentine’s Day in the ER not that long ago on a kind of like a pinched nerve lumbar situation. Yeah. I’ve never seen her in so much pain in my life for hours and hours and hours and like.

You know, we went to one of the nicer ERs up here, actually drove an extra 45 minutes and, um, not naming the hospital. Um, we, uh, yeah, it got delayed ’cause there was like an emergency kind of helicopter landing where somebody was way more in a acute danger. Mm-hmm. But, you know, the, the treatment was IV [01:05:00] acetaminophen.

And I’m like, you know, on one hand cool, but like when we left the, the pain wasn’t really any better at all. And I’m hear it like, okay, like okay, she could kind of walk, but like barely. And I’m like, you know, somebody with a little more fluency and I little less fear. Sure. You know, um, that could have been a much better scenario.

Mm-hmm. Um, and I’m like, oh God. So like, you know, um, yes, in some cases we need to use less opioids as, you know, we’ll speak for clinicians. Yes. A little bit less opioids for sure. Sure. Especially in the chronic aspect. Mm-hmm. But like this idea around like. Insurance providers, hospitals kind of directing how clinicians should be doing care as opposed to clinicians operating in the way they think is best.

Preach is just outrageous anyway, and we’ve

Dr Case Newsom: got, we’ve gotten so used to it, unfortunately. Mm-hmm. Because you cannot take care of patients in any other way. Uh, you know, like we, we are, we are always beholden to many different, um, [01:06:00] priors

Joe Moore: mm-hmm.

Dr Case Newsom: That the establishment situates on the shoulders of a physician, you know?

Mm-hmm. And this is a huge discussion. Like, I, I love the hospital that I work at. I love all the people that I work with. It’s just that it’s so much deeper than that even, you know? Mm-hmm. And the situation with the IV acetaminophen. It’s a great medicine. It’s not necessarily comprehensive for each person, but now you’ve created something like an order set where it’s like, don’t use opiates, use this.

And you just like click the thing and then you move on. ’cause you’ve got so many patients to see

Joe Moore: and that person needs

Dr Case Newsom: to leave and it’s just, and they can walk. That means they’re good. And it’s like we have only at the bare minimum addressed the emergency quote unquote, by making sure that they’re safe.

Joe Moore: Yeah.

Dr Case Newsom: But like we really, with a little bit more thoughtfulness and this can become kind of natural. It’s not like this is a struggle every time you can make it so that you’re actually really benefiting that person and they’re feeling that they’ve been more cared for. And this is both. Medicinal and otherwise, like, it’s, it can be also just with your presence and helping co the do piece, the osteopathic piece.

[01:07:00] I would love to talk to your partner mm-hmm. And be like, okay, what led to this? Like mm-hmm. How can you do some reparative movements? Right? How do you orient your days around, like the right kind of getting stuff loosened up and healing up, you know, and like, no IV drug is gonna do that. It’s all of it.

This is,

Joe Moore: this is, uh, my role in the relationship and I, I did, uh, I did a, a really ridiculous mountain bike crash ages ago. Drove myself to the ER after peeing blood, and then I was like, I, I was hesitating to hear that. Do I need attention? And like it took hours. ’cause I was so dehydrated. And I was like, uh, and then I called my military vet buddy and he’s like, no, I’ve never seen that.

You should probably go to the house. I drove myself there after doing all sorts of really intense work was so, and I was refusing pain meds the whole time. Wow. And then I got to do a three day stay after getting a taste for Dilaudid at, um, St. Anthony’s West ICU for a bit, which is, you know, it was a good learning experience.

Mm-hmm. I’m a little more chill [01:08:00] and now I know to not refuse pain meds when uh, they’re offered. Yeah. I’m sorry

Dr Case Newsom: that happened. That sounds like a terrible episode.

Joe Moore: Yeah. You know. Thank you. But I’m, I’m mostly, mostly better. Everything, everything,

Dr Case Newsom: everything leads us to right where we are. Right,

Joe Moore: exactly. So where can people follow you and Zendo and Stadium?

Dr Case Newsom: Oh, excellent. Um, so I am personally on Instagram, um, at Case New something. Um, there’s also zendo project.org, uh, and Zendo project is on Instagram as well. Um, and frankly if you wanna sign up for our email listserv, there is like a volunteer interest form on the website and, uh, we service that every day.

Um, we have a spectacular team that runs tech for us. Um, shout out to Armando Jessa, Jess. Um, they do a great job, um, and all volunteer interest is heard and responded to. Um, yeah, and we have a, a monthly newsletter that comes out to emails. Um, and then we’re always [01:09:00] posting updates on our, our various socials about events that we’re gonna get into.

Um, we’ve got a couple coming down the pike. Especially at Red Rocks, I’m super excited about. I cannot wait. Um, yeah, there’s a real blossoming of the Zendo project and it’s gonna take more hands on deck, so any interest is appreciated. Please reach out.

Joe Moore: Yeah. And second it on the training, everybody says it’s extraordinary somehow.

I haven’t taken it yet, but I’ll get there. Oh, you haven’t taken the SIT training? Get me in. Get me in. We’ll do it. Oh,

Dr Case Newsom: it is, it is first class, I think. Mm-hmm. It, it is so excellent. Yeah. Um, Tim and Simone are fantastic educators building on, uh, Sarah and Ryan and some of the legacy work that’s happened at Zendo that founded the organization.

It’s just, I just couldn’t be more inspired by these individuals I work with. I say it all the time. I found a wellspring of inspiration. Mm. And I hope that everybody can find that particular setting to really express their own skillset.

Joe Moore: All right. Dr. Casey Sen, thanks so much.

Dr Case Newsom: Thank you, Joe. This is really a delight.